Provider Demographics
NPI:1073985867
Name:BANDAY, SANA (DMD)
Entity Type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:BANDAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WORCESTER ST APT 503
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3377
Mailing Address - Country:US
Mailing Address - Phone:857-654-8983
Mailing Address - Fax:
Practice Address - Street 1:171 WATERTOWN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2571
Practice Address - Country:US
Practice Address - Phone:617-467-5113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist